States that have expanded Medicaid under ACA will be reimbursed 100% by the Federal government for the next few years. Those that haven't will just have to swallow it and pass it to the state taxpayers as Florida is doing in the case of Edward's mother-in-law. They can't bill California Medicaid which has federal Medicaid money which Florida does not qualify to receive because, so far, they have rejected Mediaid Expansion.

I believe the above statement is a bit incorrect. In the situation given by the OP the Florida facility declined to bill Medi-Cal because it has not signed as a participating facility. For whatever reason they have simply chosen not to do so. It has nothing at all to do with expanded Medicaid. It is a choice made by the Florida facility.

The facility could, if the powers that be choose to, sign a participating agreement with California and bill accordingly. They have chosen not to do so and for that reason, and that reason alone, they do not bill Medi-Cal. It is their decision. The facility is qualified to receive funds from Medi-Cal if they wished to participate. They have not "rejected Mediaid Expansion" but they do not wish to have a billing agreement with California's Medi-Cal program.

But Florida HAS rejected the Federal Medicaid program, and if they HADN'T they would have been able to simply bill Medicaid.

not true - they always could have billed medical - the rules for doing so have not changed - if the hospital signs up to be an out of state provider they can bill medical and will be paid

this was true before the ACA and it is still true

this is the point Dave - the ACA mandated that some people get coverage through expanded medicaid, but they have not mandated that every state sign up for or accept every other states medicaid - and this is despite the fact that medicaid has always been a jointly funded system between each state and the federal government

They DID mandate that Edward. The Court struck it down.

the expansion of medicaid only increased who could be covered in each state - - it never required that other states accept it even though in many cases it is the only insurance these people have

If the ACA were going to mandate that some people get put on medicaid then it also should have changed the rules on out of state acceptance of medicaid - it failed to address this issue.

It did indeed address these issues, but when the Supreme Court validated the Constitutionality of the ACA, at the same time it removed the compulsary part of Medicaid, and allowed them to accept or reject it.